New concept in histopathological grading and staging of chronic hepatitis C infection at Sharkia Governorate, Egypt

In this study, the Knodell histology activity index and the semi- quantitative reproducible description of the various morphological lesions of chronic hepatitis were applied on 109 liver biopsies taken from Egyptian patients infected with hepatitis C virus [HCV]. It was found that the presented histopathological features may be unusual for any of the known scoring systems. Therefore, a new system was suggested for grading and staging of liver diseases in Egyptian patients infected with HCV. Accordingly, the degrees of necro- inflammations are classified into 3 grades [1-3] and the progression of fibrosis is classified into 3 stages [1-3]. The reduced numbers of grades and stages proposed in this study may be attributed to the rapid course among Egyptians who differ in the environmental circumstances

Molecular cytogntic profiles of hepatitis C infection in patients at Sharkia Governorate, Egypt

In this study, 40 paraffin blocks liver tissues from HCV-PCR positive patients [HBV seronegative] were examined using DNA image cytometry to evaluate its role in diagnosing hepatocellular carcinoma [HCC] associated with hepatitis C virus [HCV] infection. Fluorescent in situ hybridization [FISH] technique using LSIZNF 217 chromosome 20q 13.2 probe was applied. The results showed a high percentage of S- phase fraction in cases of G2S2 and G3S3 with DNA diploidy. Only two cases of G3S3 showed DNA aneuploidy with a severe amplification of chromosome 20q 13.2. Consequently, DNA imaging cytometry is considered a good approach in differentiating dysplasia from well- differentiated HCC on the top of HCV infection. In conclusion, HCV has an acquired role in the development of HCC through the amplification of the aggressive tumor behavior oncogene LSIZNF 217 at chromosome 20q 13.2

Non-invasive markers and predictors of severity of hepatic fibrosis in HCV patients at Sharkia Governorate, Egypt

This study included 109 patients with detectable hepatitis C virus [HCV] by real time PCR. The patients were classified into three different pathological stages and grades according to the new concept of histopathological staging and grading. The different clinical, biochemical, virological and ultrasonographic parameters were assessed and analyzed and the variables that showed a significant association with the histopathological staging and grading were included in the multivariate logistic regression analysis. The regression model revealed that platelet count, matrix metalloproteinase-9 [MMP-9], portal vein diameter, splenic longitudinal axis, alanine transaminase, aspartate transaminase and viral load added a significance to the model in a decreasing order of significance. From these findings, a new score ranged from 0-9 was generated. The score model was applied to the patients to assess its validity, where it proved to be accurate in discriminating patients with mild inflammation and fibrosis [sensitivity 81.8%, specificity 80.5% and accuracy 80.7%] and more accurate in detecting patients with cirrhosis [specificity 96.6%, sensitivity 80% and accuracy 93.6%], but less accurate in detecting patients with moderate to severe fibrosis [specificity 66.7%, sensitivity 68.7% and accuracy 67.9%]. Also, the results revealed that co-infection with schistosomiasis, old age >/45 years and positive history of blood transfusion as a source of infection were significantly associated with severe hepatic pathology